What is a NPI and How Do You Get One?

If you’ve just graduated from your nurse practitioner program, you are likely overwhelmed by the number of licenses and certifications NPs are required to obtain. There’s a DEA number if you plan to prescribe controlled substances, a state NP license, and a national certification. In addition, all healthcare providers, nurse practitioners included, must apply for a National Provider Identifier (NPI).

So, what exactly is a NPI, why do you need it, and how do you get one?

What is a National Provider Identifier?

A National Provider Identifier, commonly known as NPI, is a unique 10 digit identification number given to healthcare providers by the Centers for Medicare and Medicaid Services (CMS). In this case, healthcare providers include individuals, groups, or organizations that provide medical or other health services or supplies. The NPI was established as part of the 1996 Health Insurance Portability and Accountability Act (HIPAA) that required the adoption of a standard, unique identifier for healthcare professionals. While the identifier was mandated by the 1996 law, NPIs were not issued until 2006.

All healthcare providers or organizations covered by HIPAA, from physicians and nurse practitioners to social workers and home health agencies must obtain a NPI. Health industry workers such as medical billing personnel or hospital housekeeping staff who do not provide direct healthcare are not required to have a NPI. A provider’s NPI does not change and stays with the provider regardless of job or location changes.

Are You Ready to Thrive?

Learn more about our online residency program; we pair clinical and professional development to take advanced practice providers to the next level. Get More Info>>

What is a NPI used for?

Before the NPI, there was no standard method for identifying healthcare providers. This lack of coordination was confusing and inefficient. So, the NPI was introduced.

The NPI is used by healthcare providers to identify themselves and other healthcare providers in healthcare transactions or correspondence. It may be used by pharmacies to identify providers on prescriptions (the NPI does not replace a DEA number). Insurance companies and health plans also use the NPI to process claims. Finally, the NPI is used by electronic medical record systems to identify providers in patient records.

Is my NPI confidential?

A provider’s NPI is not confidential. An online NPI Registry allows anyone to look up a provider’s NPI at any time. The registry lists the provider’s NPI as well as other information such as practice address and licensing information.

How do nurse practitioners apply for a NPI?

To apply for a NPI, visit the National Plan and Provider Enumeration System (NPPES) website and create a login. You will need your licensing information, so have your state RN and APRN license handy. The process is free and easy.

 

You Might Also Like: Writing Prescriptions as a Nurse Practitioner- The FAQ’s

 

11 thoughts on “What is a NPI and How Do You Get One?”

  1. As a new grad in California I have already received my state NP license number but am still waiting on my furnishing number. Can I apply for my NPI now? When can I apply for my DEA?

  2. Hi Becky, 

    You may apply for your NPI if you have your license. You will need to wait for your furnishing number to apply for your DEA. 

  3. Hello, I am a Licensed Clinical Social Worker in the the states of MI and Washington, D.C. I previously had an NPI number and would like to know how do I reactivate that number or how do I obtain a new NPI number to practice as an Independent provider for Medicare and Medicaid? are youable to assist me?

  4. Rose-Ann Richards

    I’m a new NP in CT I have NP license and ANCC board certification. I tried to start the process of applying fo NPI and DEA #s but each were asking for physical Buisness Address. Do I have to get a job first before I apply?

  5. Louann Cranford

    I am a LMT and am working to become a VA provider but am being told I need a NPI. Where do I go to apply for a number and how long does it normally take to get? I have a client who needs massage to help with chronic pain. The VA has a trial program to monitor how well massage helps with pain reduction and has authorized her visits.

  6. Hello. I applied for an NPI number through this site. I was issued a number. The number is not recognized by CMS in GA. Can anyone contact me?

    Joi Blanding, NP

Leave a Comment

Your email address will not be published. Required fields are marked *

Share Post:

Share on facebook
Share on twitter
Share on linkedin

Are you ready to Thrive?

Support + education for early career nurse practitioners.

Have you signed up for our newsletter?

Stay up to date with the latest advanced practice news!

Are you struggling as an early career NP or PA?

Learn more about ThriveAP, the program designed to boost primary care clinical knowledge.

Support and education for early career NPs & PAs

Download the ThriveAP info
packet for more information!

Are You Employed
Hidden
This field is for validation purposes and should be left unchanged.